The Department of Human anatomyThe Department of Human anatomy

Blood Supply (Arteries and Veins) of

Head and Neck

Arterial and venous anastomoses

PLANPLAN 1. 1. The coomon carotid arteryThe coomon carotid artery a)a) topography topography - - carotid sinus carotid sinus -- carotid bodycarotid body 2. Neurovascular bundles of the neck2. Neurovascular bundles of the neck 3. The external carotid artery3. The external carotid artery 4. 4. The internal carotid arteryThe internal carotid artery - - arterial supply of the brainarterial supply of the brain 5. 5. Arterial anastomoses head and neckArterial anastomoses head and neck 6. Veins of the head and neckeins of the head and neck

Topicality:Topicality: Knowledge of blood supply of the Knowledge of blood supply of the

brain is important for you, becouse brain is important for you, becouse cerebro-vascular pathology is an cerebro-vascular pathology is an actual problem in all countries. actual problem in all countries. Vascular disease of the brain is 30-Vascular disease of the brain is 30-50% of diseases of the vascular 50% of diseases of the vascular system. Mortality from ynsultsystem. Mortality from ynsult is 12-is 12-15% of total mortality.15% of total mortality.

The branches of aortic arch The branches of aortic arch Aortic arch has three Aortic arch has three

major branchesmajor branches1) 1) BrachiocephalicBrachiocephalic trunc trunc

(artery) (artery) divided into:divided into:

Right subclavianRight subclavian Right common carotidRight common carotid2) 2) Left common carotidLeft common carotid

divided into:divided into:

External carotidExternal carotid Internal carotidInternal carotid3) 3) Left subclavianLeft subclavian   

The common carotid arteryThe common carotid arteryThe common carotid artery runs upwards in the neck to

the upper border of the

thyroid cartilage.

Then it divides into external and internal

carotid arteries.

Attention: to stop

bleeding of the common

carotid artery, need to

pressed the artery to the

сarotic tubercle of the sixth cervical

vertebra.

Carotid triangle is formed

Carotid Sinus- Carotid Sinus- this is the small balloon this is the small balloon like structure at the start of the like structure at the start of the internal carotid artery. The dilation internal carotid artery. The dilation sometimes extends to the common sometimes extends to the common carotid artery. The carotid sinus is carotid artery. The carotid sinus is a barometer that monitors arterial a barometer that monitors arterial blood pressure.blood pressure.

Carotid Body- Carotid Body- this is a small oval mass this is a small oval mass located at the bifurcation of the located at the bifurcation of the common carotid artery, between common carotid artery, between the two branches – internal and the two branches – internal and external carotid arteries. It is a external carotid arteries. It is a chemoreceptor that monitors the chemoreceptor that monitors the oxygen levels in the blood.oxygen levels in the blood.

.

.

Carotid Reflex Zone

I (main) under under m.sternocleidomastoideus m.sternocleidomastoideus

and consists of:and consists of:

- a. carotis communis - v. jugularis interna - n. vagus

Neurovascular bundle Neurovascular bundle of the neckof the neck

II (in the lateral triangle)in the lateral triangle)

- a. subclavia- a. subclavia- - v. subclaviav. subclavia- pars supraclavicularis plexus brachialis

I. Front (anterior) group: - superior Thyroid Artery - the Lingual Artery ( lies in the triangle

Pirogov) - Facial Artery II. Posterior group: - the Occipital Artery - the Posterior Auricular Artery - Sternocleidomastoideus BranchIII. Medial group: - the Ascending Pharyngeal Artery IV. Terminal branches - superficial Temporal Artery - the Maxillary Artery Major branches of the Maxillary Artery: 1. Infraorbital artery2.   Posterior superior alveolar artery

3.   Inferior alveolar artery

The external carotid artery It supplies structures external to the skull.

Branches a. maxillaris

The Internal Carotid Artery The Internal Carotid Artery it has 4 it has 4

parts:parts:AA. . Cervical, Cervical, BB. Petrous, . Petrous, CC. Cavernous, . Cavernous, DD. Cerebral . Cerebral

Inside the skull the internal carotid artery gives off the ophthalmic artery which supplies the optic nerve, eye, orbit and scalp. The internal carotid arteries are two of the four main arteries that supply blood to the brain.

The internal carotid artery has no branches outside the skull and enters the skull through the carotid canal.

BranchesBranches ofof Internal Internal Carotid Artery Carotid Artery

The arterial cerebral circulation is normally The arterial cerebral circulation is normally divided into anterior cerebral circulation and divided into anterior cerebral circulation and posterior cerebral circulation. There are two posterior cerebral circulation. There are two main pairs of arteries that supply the cerebral main pairs of arteries that supply the cerebral arteries and the cerebellum: Internal carotid arteries and the cerebellum: Internal carotid arteries and vertebral arteries.arteries and vertebral arteries.

Arterial Supply of the Brain

The components:The Circle of Willis is a part of the cerebral circulation and is composed of the following arteries:-Anterior cerebral artery (left and right)-Anterior communicating artery-Internal carotid artery (left and right)-Posterior cerebral artery (left and right)-Posterior communicating artery (left and right)The basilar artery and middle cerebral arteries, supplying the brain, are also considered part of the circle.

Arterial anastomoses head and Arterial anastomoses head and neckneck

Anastomosis ensure the normal functioning collaterals and Anastomosis ensure the normal functioning collaterals and if the blood flow in VBS is reduced they prevent the if the blood flow in VBS is reduced they prevent the development of neurological disorders.development of neurological disorders.

A. A. Intersystem between branches a. carotis externa and a. Intersystem between branches a. carotis externa and a. subclavia: subclavia:

1. a. thyroidea superior + a. thyroidea inferior 1. a. thyroidea superior + a. thyroidea inferior 2. rr. occipitales + rr. musculares2. rr. occipitales + rr. musculares 3. Circulus arteriosi cerebri3. Circulus arteriosi cerebri (The Circle of Willis)(The Circle of Willis) B. B. Intersystem between branches a. carotis externa and a. Intersystem between branches a. carotis externa and a.

carotis interna:carotis interna: 1. a. angularis + a. dorsalis nasi1. a. angularis + a. dorsalis nasi 2. a. zygomaticoorbitalis + a. supraorbitalis et a.lacrimalis2. a. zygomaticoorbitalis + a. supraorbitalis et a.lacrimalis C. C. AAnastomoses within the pool a. carotis internanastomoses within the pool a. carotis interna 1. a.a. palpebrales laterales+ a.a. palpebrales mediales1. a.a. palpebrales laterales+ a.a. palpebrales mediales 2. a. communicans anterior2. a. communicans anterior

D. AD. Anastomoses within the pool a. carotis nastomoses within the pool a. carotis externaexterna

11. a.sublingualis(br. a. lingualis)+ a.submentalis (br. a. . a.sublingualis(br. a. lingualis)+ a.submentalis (br. a. facialis).facialis).

22.. a.palatina ascdendens(br.a.facialis)+ a.pharyngea a.palatina ascdendens(br.a.facialis)+ a.pharyngea ascdendens(br.a.carotis externa).ascdendens(br.a.carotis externa).

33.rr.occipitalis(br.a.occipitalis).rr.occipitalis(br.a.occipitalis)+rr.occipitalis(br.a.auricularis posterior)+rr.temporalis +rr.occipitalis(br.a.auricularis posterior)+rr.temporalis superficialis(br.a.carotis externa).superficialis(br.a.carotis externa).

44. a.transversa faciei (br.a.temporalis superficialis)+ br. . a.transversa faciei (br.a.temporalis superficialis)+ br. a. facialis(a.carotis externa). a. facialis(a.carotis externa).

55.a.mentalis(a.maxillaris)+a.labialis inferior et .a.mentalis(a.maxillaris)+a.labialis inferior et a.submentalis (br. a. facialis).a.submentalis (br. a. facialis).

66. a.buccalis(br.a.maxillaris)+ rr.a.facialis(a.carotis . a.buccalis(br.a.maxillaris)+ rr.a.facialis(a.carotis externa).externa).

77. a.palatina major (rr.palatina descendens a. . a.palatina major (rr.palatina descendens a. maxillaris) + a.nasalis posterior septi maxillaris) + a.nasalis posterior septi (rr.a.sphenopalatina a. maxillaris).(rr.a.sphenopalatina a. maxillaris).

88. a.palatina descendens (br.a.maxillaris)+palatina . a.palatina descendens (br.a.maxillaris)+palatina ascendens(br.a facialis). ascendens(br.a facialis).

99. a.nasalis posterior septi (rr.a.sphenopalatina a. . a.nasalis posterior septi (rr.a.sphenopalatina a. maxillaris)+ a.labialis superior (br.a facialis). maxillaris)+ a.labialis superior (br.a facialis).

1010. rr.auricularis anteriores (rr.a.temporalis . rr.auricularis anteriores (rr.a.temporalis superficialis)+rr.auricularis (br.a.auricularis superficialis)+rr.auricularis (br.a.auricularis posterior).posterior).

1111. a.infraorbitalis + a.labialis superior.+ . a.infraorbitalis + a.labialis superior.+ a.zygomaticoorbitalis.a.zygomaticoorbitalis.

C. C. Between equal branches opposite Between equal branches opposite sidessides

1. 1. r. infrahyoideus (br.a.thyroidea superior a.carotis r. infrahyoideus (br.a.thyroidea superior a.carotis externa).externa).

22. r. cricothyroideus (br.a.thyroidea superior a.carotis . r. cricothyroideus (br.a.thyroidea superior a.carotis externa).externa).

33. r. suprahyoideus (br.a.lingualis a.carotis externa).. r. suprahyoideus (br.a.lingualis a.carotis externa). 44. rr.dorsalis lingue (br.a.lingualis a.carotis externa).. rr.dorsalis lingue (br.a.lingualis a.carotis externa). 5. 5. aa. labialis superior et inferior (br.a.facialis a.carotis aa. labialis superior et inferior (br.a.facialis a.carotis

externa).externa). 66. rr. occipitalis (br.a.occipitalis a.carotis externa).. rr. occipitalis (br.a.occipitalis a.carotis externa). 77. r. parietalis (br.. r. parietalis (br.a.temporalis superficialis a.temporalis superficialis a.carotis a.carotis

externa).externa). 88. a. supratrohlearis (br. a.ophthalmica. a. supratrohlearis (br. a.ophthalmica a.carotis a.carotis

externa).externa).

The Veins of the Head and The Veins of the Head and NeckNeckThe veins, which return the blood from the head

and neck, are: 1. Internal Jugular. The jugular veins are veins that bring deoxygenated blood from the head back to the heart via the superior vena cava.It is somewhat dilated at its origin, and this dilatation is called the superior bulb.It also has a common trunk into which drains the anterior branch of the retromandibular vein, the facial vein, and the lingual vein.It runs down the side of the neck in a vertical direction, being at one end lateral to the internal carotid artery, and then lateral to the common carotid, and at the root of the neck, it unites with the subclavian vein to form the brachiocephalic vein (innominate vein); a little above its termination is a second dilatation, the inferior bulb. 2. External Jugular. 3. Anterior Jugular. 4 Vertebral

•.

The exstracranial The exstracranial tributaries of thetributaries of the Internal Jugular Internal Jugular

veinvein1.The facial vein and the 1.The facial vein and the

deep facial vein.deep facial vein.2 The angular vein.2 The angular vein.3. The retromandidular vein.3. The retromandidular vein.4. The superficial temporal 4. The superficial temporal

vein.vein.5. The maxillary vein.5. The maxillary vein.6. The lingual vein6. The lingual vein7. The superior thyroid vein7. The superior thyroid vein

The intracranial tributaries of The intracranial tributaries of thethe Internal Jugular vein Internal Jugular vein

The venous drainage of the head and neck begins as drainage of the brain. There are:

Venous sinusesVenous sinusesName Drains toInferior sagittal sinus Straight sinus

Superior sagittal sinus Typically becomes right transverse sinus

Straight sinus Typically becomes left transverse sinus

Occipital sinus Confluence of sinuses

Confluence of sinuses Reference point, not an actual sinus

Sphenoparietal sinuses Cavernous sinuses

Cavernous sinuses Superior and inferior petrosal sinuses

Superior petrosal sinus Transverse sinusesTransverse sinuses Sigmoid sinusInferior petrosal sinus Sigmoid sinusSigmoid sinuses Internal jugular vein

The cerebral veinsThe cerebral veins The The cerebral veinscerebral veins are are

divisible into superficial divisible into superficial and deep groups.and deep groups.

The superficial veins are The superficial veins are the:the:

a) superior cerebral veinsa) superior cerebral veins b) inferior cerebral veinsb) inferior cerebral veins c) c) middle cerebral vein.middle cerebral vein. The deep veins are the:The deep veins are the: a) internal cerebral veinsa) internal cerebral veins b) great cerebral veinsb) great cerebral veins

The ophthalmic veins drain the constituents The ophthalmic veins drain the constituents of the orbit.of the orbit.1. The superior ophthalmic vein.1. The superior ophthalmic vein.2. The inferior ophthalmic vein.2. The inferior ophthalmic vein.

The ophthalmic veins

The diploic veins The emissary The diploic veins The emissary veinsveinsThe diploic veins are the The diploic veins are the

thinwallrd veins embedded thinwallrd veins embedded into the cancellous bone into the cancellous bone of calvaria.of calvaria.

1.1. The frontal diploic vein.The frontal diploic vein.2.2. The anterior temporal The anterior temporal

diploic vein.diploic vein.3.3. The posterior temporal The posterior temporal

diploic vein.diploic vein.4.4. The occipital diploic veinThe occipital diploic vein

The The emissary veinsemissary veins are are valveless veins which valveless veins which normally drain from the dural normally drain from the dural venous sinuses into veins that venous sinuses into veins that lie outside the skull.lie outside the skull.

1. The parietal emissary veins.1. The parietal emissary veins. 2. The mastoid emissary veins.2. The mastoid emissary veins. 3. The condylar emissary veins.3. The condylar emissary veins. 4. The occipital emissary veins.4. The occipital emissary veins.

Thank you for attention!